西药联合微波治疗带状疱疹后遗神经痛的效果探讨

目的 探讨西药联合微波治疗带状疱疹后遗神经痛患者的临床效果.方法 60例带状疱疹后遗神经痛患者作为研究对象,以随机数字表法分为观察组和对照组,各30例.对照组患者予以常规西药治疗,观察组患者在对照组基础上联合微波治疗.比较两组患者的治疗效果、不良反应发生情况及疼痛缓解、疼痛消除时间.结果 观察组患者治疗总有效率96.6...     

神经阻滞加微波治疗带状疱疹后遗神经痛

我们于1999～2004年收集了45例带状疱疹后遗神经痛病人，经神经阻滞加微波治疗收到较好的临床效果，现报道如下：     

神经阻滞联合微波治疗带状疱疹后遗神经痛的临床研究

目的观察神经阻滞联合微波治疗带状疱疹后遗痛的疗效。方法选择80例带状疱疹后遗痛患者，随机分为两组，A组采用维生素B12维生素B1联合消炎痛治疗；B组采用神经阻滞联合微波治疗。分别于治疗后1d，3d，7d，14d用视觉模拟评分法（VAS）对两组患者疼痛和睡眠程度进行评分。结果两组患者经治疗后，VAS评分有显著性差异（P〈0．001），B组患者的止痛效果和睡眠质量明显优于A组。结论神经阻滞联合微波治疗带状疱疹后遗神经痛，疗效显著而安全。     

针灸联合微波治疗带状疱疹后遗神经痛的效果观察

目的探讨针灸联合微波治疗带状疱疹后遗神经痛的临床疗效。方法以本社区2010年4月至2012年9月期间的114例带状疱疹后遗神经痛患者为研究对象,随机分为均等的两组。观察组采用微波联合针灸治疗,对照组采用针灸治疗。1个月后评价两组的临床疗效。结果观察组患者治疗的总有效率为96.5%,对照组患者治疗的总有效率为86.0%,两组患者在治疗的总有效率间存在统计学差异(P<0.05)。结论针灸联合微波治疗带状疱疹后遗神经痛的临床疗效显著优于单纯的针灸治疗,值得进一步推广应用。     

带状疱疹后遗神经痛的治疗进展综述

带状疱疹后遗神经痛是由水痘疱疹病毒引起的带状疱疹在皮损愈合后疼痛持续1个月以上的慢性神经痛综合征。老年患者发病率较高,并随着年龄的增加而增加,英国相关报告指出:年龄<50岁人群相对罕见(每年<2/1000);50～79岁人群每年为5～7/1000,≥80岁的人群,发病率为每年11/1000[2]。本病是一种顽固难治性疾病,给患者的心理和生理造成很大的痛苦,其发病机制为患者免疫力低下时水痘疱疹病毒破坏受累神经分布区域的神经,使其产生剧烈的疼痛。目前本病缺乏有效的治疗方法,近年来国内外对此作了较广泛的研究,取得了一定进展。本文就目前带状疱疹后遗神经痛的治疗方法的进展加以综述。     

带状疱疹后遗神经痛的护理

目的探讨带状疱疹后遗神经痛的临床护理方法及护理经验。方法 2013年3月至2016年1月本院收治的66例带状疱疹后遗神经痛患者采取药物治疗、心理护理、疼痛护理、饮食指导、物理治疗等措施。结果通过采取实施全面、系统的护理,66例带状疱疹后遗神经痛的患者中疼痛较治疗前减轻61例,加重1例,无改变4例。结论对带状疱疹后遗神经痛患者采用综合全面的护理干预措施,可以有效消除患者的疼痛,在一定程度上提高带状疱疹后遗神经痛的临床治疗效果,提高患者的生活质量,值得临床推广应用。     

中西医结合治疗带状疱疹后遗神经痛

目的分析中西医结合方案对带状疱疹后遗神经痛的疗效。方法将52例带状疱疹后遗神经痛患者随机均分为对照组和观察组,前者予常规西医治疗,后者在此基础上联合应用中药益气活血汤。观察疗效、多时点VAS评分、不良反应。结果观察组总有效率显著高于对照组,治疗1、2、4、8周时VAS疼痛评分均显著低于对照组,上述差异均有统计学意义(P<0.05)。两组均见少量一过性不良反应,且发生率无显著差异(P>0.05)。结论中药益气活血汤有助于提升西药对带状疱疹后遗神经痛的疗效,值得推广。     

加巴喷丁治疗带状疱疹后遗神经痛的护理

目的：分析加巴喷丁治疗带状疱疹后遗神经痛的护理。方法选取本院收治的70例带状疱疹后遗神经痛患者进行本次研究,将患者按数字表法分为对照组和观察组,每组35例患者。两组患者均给予加巴喷丁进行治疗,同时对照组患者给予常规护理;观察组患者治疗的同时给予综合性护理干预措施。对比观察两组患者的SAS、PSQI及VAS评分。结果护理后观察组患者的SAS评分、PSQI评分及VAS评分分明显低于对照组,差异均具有统计学意义（P<0.05）。结论加巴喷丁治疗带状疱疹后遗神经痛后采取综合护理措施,效果明显,极大程度缓解了患者的疼痛,减轻了心理负担,焦虑情绪得到有效改善,有利于患者睡眠质量的提高,意义重大。     

带状疱疹后遗神经痛的护理

目的：分析带状疱疹后遗神经痛的护理。方法88例带状疱疹后遗神经痛患者随机分为观察组和对照组,每组44例,观察组采取护理干预,对照组采用常规护理,对比两组患者护理效果。结果两组护理后疼痛程度、焦虑情绪明显减轻,睡眠质量显著提高,与护理前对比,差异具有统计学意义(P<0.05),两组间对比,差异具有统计学意义(P<0.05)。结论加强带状疱疹后遗神经痛的护理干预,可减轻患者疼痛,提高患者生活质量,值得临床进行推广和使用。     

加巴喷丁胶囊治疗带状疱疹后遗神经痛效果分析

目的探讨加巴喷丁胶囊治疗带状疱疹后遗神经痛的疗效。方法将98例带状疱疹后遗神经痛患者按就诊顺序奇偶分为观察组和对照组,观察组49例在常规治疗基础上给予加巴喷丁胶囊治疗,对照组49例在常规治疗的基础上给予布洛芬胶囊治疗,对比两组的治愈率、治疗前后视觉模拟评分法(VAS)和不良反应情况。结果观察组治愈率高于对照组,但两组差异无统计学意义;治疗后,两组VAS评分均明显低于治疗前,且观察组评分明显低于对照组,差异有统计学意义;治疗中,观察组不良反应发生率低于对照组,但差异无统计学意义。结论加巴喷丁胶囊治疗带状疱疹后遗神经痛安全有效,能明显减轻患者神经性疼痛症状。     

Treatment of post herpetic neuralgia in the elderly

The incidence of acute herpes zoster and post herpetic neuralgia (PHN) increases with age. PHN resolves spontaneously within three months in approximately 50% of cases, although 22% experience discomfort for more than a year. There is little good evidence that treatment with antiviral agents, corticosteroids, local and regional anaesthesia, amantadine or levodopa in the acute stage can prevent the development of PHN. However, few studies have sufficient statistical power to allow firm conclusions to be drawn. Amitriptyline is beneficial in patients with established PHN and has an analgesic effect which is independent of its antidepressant action. Anticonvulsants and neuroleptics are of unproven efficacy and should be avoided in the elderly as side effects are common. Various local anaesthetic and surgical techniques may provide temporary relief in individual patients although none has been shown to produce consistent benefit. Transcutaneous electrical nerve stimulation (TENS) is free from adverse effects and appears to benefit some patients. Intractable pain often results in over-prescribing with the risk of adverse drug reactions. Drug therapy should be minimized with careful assessment of the risk/benefit ratio for any additional medication.     

微波定向照射治疗带状疱疹的临床疗效观察

目的：评价微波治疗仪定向照射对带状疱疹的疗效及安全性。方法：178例带状疱疹患者随机分成两组，试验组在抗病毒治疗的基础上用微波定向照射治疗。微波功率25～30W，频率2450MHz，用微波照射探头直接对准受损神经根部，并沿神经纤维末梢走向部位移动照射或在水疱、渗出的部位，按疼痛轻重依次照射，根据皮疹及疼痛部位的大小设定照射时间20～30分钟，距离0．5cm，皮温40～50度，每日1次，共8次。对照组除不用微波定向照射外其它抗病毒治疗同试验组。结果：试验组止痛、止疱、结痂时间明显短于对照组，总有效率试验组为84、8％，对照组为69．9％，两组相比差异有显著性（P〈0．01）无其他不良反应发生，结论：微波定向照射治疗带状疱疹安全有效。     

早期干预治疗带状疱疹预防后遗神经痛的临床研究

目的探讨穴位注射早期干预与带状疱疹及后遗神经痛(PHN)的关系。方法将240例带状疱疹患者随机分为对照组(80例)给予阿昔洛韦静滴,半导体激光照射;治疗组(160例)加维生素B1、腺苷钴胺穴位注射,每日一次,疗程10d。观察治疗前后疼痛评分、睡眠质量评分、疼痛频率,综合评估疗效。随访3个月统计PHN发生率。结果治疗组痊愈率,总有效率,治疗后综合评估均明显优于对照组,3个月后PHN发生率低于对照组(P<0.05)。结论穴位注射早期干预治疗带状疱疹能迅速缓解疼痛,治愈率高,PHN发生率低。     

两种药物联合治疗带状疱疹的疗效及对后遗神经痛影响

目的探讨应用复方甘草酸苷与阿昔洛韦治疗带状疱疹的效果。方法选择笔者所在医院2005年1月～2008年2月入院治疗的120例带状疱疹患者临床资料,根据治疗方法不同进行随机分组,其中治疗组60例给予阿昔洛韦联合复方甘草酸苷治疗,对照组60例给予泛昔洛韦治疗,比较两组患者的临床疗效。结果治疗组止疱、结痂、止痛时间及痊愈时间均较对照组缩短;治疗组有效率超过对照组,差异有统计学意义(P<0.05)。治疗组神经痛者有7例(11.67%),而对照组有19例(31.67%),两组发生率比较差异有统计学意义(P<0.01)。治疗组出现胃肠道不适2例,头痛3例,血压轻度升高1例;对照组出现胃肠道不适4例,均未影响治疗。结论复方甘草酸苷联合阿昔洛韦较单用泛昔洛韦常规疗法治疗带状疱疹效果明显,可以使皮疹消退快,缓解疼痛迅速,疗程缩短,且安全性好,值得临床推广应用。     

加巴喷丁治疗带状疱疹后遗神经痛疗效

目的 探讨加巴喷丁对带状疱疹后遗神经痛的疗效.方法 带状疱疹后遗神经痛患者46例,随机分为两组:A组24例,在常规治疗基础上加用加巴喷丁;B组22例,常规治疗加用卡马西平治疗.采用视觉模拟评分(VAS)进行疼痛评估,评价两组疗效.结果 A组临床治疗有效率为87.50%,明显高于B组的68.18%(P＜0.05).结论 加巴喷丁治疗带状疱疹后遗神经痛疗效优于卡马西平,且疗效持久,副作用少而轻微.     

Management of herpes zoster (shingles) and postherpetic neuralgia

Herpes zoster (HZ) results from recrudescence of varicella zoster virus latent since primary infection (varicella). The overall incidence of HZ is ～ 3/1000 of the population per year rising to 10/1000 per year by 80 years of age. Approximately 50% of individuals reaching 90 years of age will have had HZ. In ～ 6%, a second attack may occur (usually several decades after the first). Patients with HZ can transmit the virus to a non-immune individual causing varicella. HZ is not contracted from individuals with varicella or HZ. Reduced cell-mediated immunity to HZ occurs with ageing, explaining the increased incidence in the elderly and from other causes such as tumours, HIV and immunosuppressant drugs. Diagnosis is usually clinical from typical unilateral dermatomal pain and rash. Prodromal symptoms, pain, itching and malaise, are common. The most common complication of HZ is postherpetic neuralgia (PHN), defined as significant pain or dysaesthesia present ≥ 3 months after HZ. PHN results from damage and secondary changes within components of the nervous system subserving pain. Some motor deficit is common; severe and long-lasting paresis may rarely accompany HZ. More than 5% of elderly patients have PHN at 1 year after acute HZ. Predictors of PHN are, greater age, acute pain and rash severity, prodromal pain, the presence of virus in peripheral blood as well as adverse psychosocial factors. Therapy for acute HZ is intended to reduce acute pain, hasten rash healing and reduce the risk of PHN and other complications. Antiviral drugs are close to achieving these aims but do not entirely remove risk of PHN. Oral steroids show no protective effect against PHN. Adequate analgesia during the acute phase may require strong opioid drugs. Nerve blocks and tricyclic antidepressants (TCAs) may reduce the risk of PHN although firm evidence is lacking. PHN requires thorough evaluation and development of a management strategy for each individual patient. Initial therapy is with TCAs (e.g., nortriptyline) or the anticonvulsant gabapentin. Topical lidocaine patches frequently reduce allodynia. Strong opioids are sometimes required. Topical capsaicin cream is beneficial for a small proportion of patients but is poorly tolerated. NMDA antagonists have not proved beneficial with the exception of ketamine. Transcutaneous Electrical Nerve Stimulation (TENS) may be effective in some cases. HZ is a common condition. Severe complications such as stroke, encephalitis and myelitis are relatively rare whereas sight threatening complications of ophthalmic HZ are more common. PHN is common, distressing and often intractable. Good management improves outcome.     

Management of herpes zoster (shingles) and postherpetic neuralgia

Herpes zoster (HZ) results from recrudescence of varicella zoster virus latent since primary infection (varicella). The overall incidence of HZ is approximately 3/1000 of the population per year rising to 10/1000 per year by 80 years of age. Approximately 50% of individuals reaching 90 years of age will have had HZ. In approximately 6%, a second attack may occur (usually several decades after the first). Patients with HZ can transmit the virus to a non-immune individual causing varicella. HZ is not contracted from individuals with varicella or HZ. Reduced cell-mediated immunity to HZ occurs with ageing, explaining the increased incidence in the elderly and from other causes such as tumours, HIV and immunosuppressant drugs. Diagnosis is usually clinical from typical unilateral dermatomal pain and rash. Prodromal symptoms, pain, itching and malaise, are common. The most common complication of HZ is postherpetic neuralgia (PHN), defined as significant pain or dysaesthesia present >or= 3 months after HZ. PHN results from damage and secondary changes within components of the nervous system subserving pain. Some motor deficit is common; severe and long-lasting paresis may rarely accompany HZ. More than 5% of elderly patients have PHN at 1 year after acute HZ. Predictors of PHN are, greater age, acute pain and rash severity, prodromal pain, the presence of virus in peripheral blood as well as adverse psychosocial factors. Therapy for acute HZ is intended to reduce acute pain, hasten rash healing and reduce the risk of PHN and other complications. Antiviral drugs are close to achieving these aims but do not entirely remove risk of PHN. Oral steroids show no protective effect against PHN. Adequate analgesia during the acute phase may require strong opioid drugs. Nerve blocks and tricyclic antidepressants (TCAs) may reduce the risk of PHN although firm evidence is lacking. PHN requires thorough evaluation and development of a management strategy for each individual patient. Initial therapy is with TCAs (e.g., nortriptyline) or the anticonvulsant gabapentin. Topical lidocaine patches frequently reduce allodynia. Strong opioids are sometimes required. Topical capsaicin cream is beneficial for a small proportion of patients but is poorly tolerated. NMDA antagonists have not proved beneficial with the exception of ketamine. Transcutaneous Electrical Nerve Stimulation (TENS) may be effective in some cases. HZ is a common condition. Severe complications such as stroke, encephalitis and myelitis are relatively rare whereas sight threatening complications of ophthalmic HZ are more common. PHN is common, distressing and often intractable. Good management improves outcome.